The impact of the therapist's pregnancy on the dynamics of the therapeutic process.

The author discusses the impact of the therapist's pregnancy on the therapist, patient, and therapeutic work. The therapist experiences the phases of pregnancy while negotiating affective and physical changes, shifts in identity, and new demands on her repertoire of therapeutic techniques. The patient may experience anger, fear of abandonment, infantile pregnancy fantasies, intensified sexual feelings, sibling rivalry with and/or envy of the therapist, and a move to a more complex level of object relations. The interplay between patient and therapist is discussed using selected, brief, clinical vignettes. The role of the supervisor of the therapist is explored. The author proposes and develops a new view of pregnancy as consisting of five phases: prepregnancy (planning), early, middle, and late pregnancy, and postpregnancy (return and consolidation). A literature review is incorporated in the presentation of the case material. The author concludes that the therapist's pregnancy usually facilitates the therapeutic process and leads to emotional growth in the patient and the therapist.